The effects of auxiliary substances used in doping on male sexual reproductive function

Using pharmacological substances to enhance athletic performance, known as doping, is widespread in sports and bodybuilding. Doping involves substances such as anabolic steroids, selective androgen receptor modulators, peptide hormones, beta-2 adrenergic agonists, and other auxiliary substances that temporarily enhance physical performance. Although perceived as safer alternatives to traditional steroids, they pose significant health risks, including on male reproductive function. The literature was reviewed using electronic databases such as PubMed, Scopus, and Google Scholar, Out of 296 articles published until 2024, 30 were included in the study providing data on the effects of these substances on sexual-reproductive function. Although SARMs do not have adverse effects like steroids, their excessive use can suppress endogenous testosterone production, affecting spermatogenesis. Peptide hormones and beta-2 adrenergic agonists can disrupt hormonal balance, affecting the hypothalamic-pituitary-gonadal (HPG) axis, suppressing the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Myostatin inhibitors and excessive consumption of amino acid derivatives can cause hormonal imbalances and oxidative stress, affecting the quality of seminal material. Auxiliary substances with anabolic effects used in doping can have significant adverse effects on male reproductive health, such as suppression of the HPG axis, decreased testosterone, and impaired spermatogenesis. Further studies are needed to understand the exact mechanisms and long-term impact of these substances on reproductive health.